The question is often asked, “Does my medical condition qualify for Federal Disability Retirement?”, or some variation of that question.

Such a question, of course, in order to “make sense” in the context of a Federal Disability Retirement application under FERS or CSRS, must be reformulated, precisely because the manner in which it is posed produces multiple sub-questions. For, ultimately, the laws and regulations governing Federal Disability Retirement do not provide for a calculus of a mathematical correspondence, where medical condition X is considered a “qualifying” one, whereas medical condition Y fails to meet such a qualification criteria.

The sub-questions which are immediately necessitated by the originating question, involve multiple factors: Does the medical condition you suffer from impact your ability to perform one or more of the essential elements of your job? In what way? Can you describe how the medical condition impacts your ability to perform your job? Are you being medically treated for your medical condition? Will the doctor support you in your quest and application for Federal Disability Retirement benefits?

Take, for instance, the following “extreme” hypothetical, used for purposes of expanding upon the previous conceptual paradigm: Question: Does my aching right thumb qualify for Federal Disability Retirement benefits? Answer: Normally not. Sub-question: If my job requires the constant and repetitive use of my right thumb, and such use is an essential element of my job, can my aching right thumb qualify me for Federal Disability Retirement benefits under FERS or CSRS? Answer: In all likelihood, yes.

Often, it is the right question asked, and not the answer to the original question, which is the important starting point of the process in preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the Office of Personnel Management.

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, then submitting the presentation either through one’s agency (if one is still on the rolls of the Federal or Postal Service, or if separated, it has not yet been 31 days or more) or directly to the Office of Personnel Management (if one has been separated from Federal Service for 31 days or more), it is then the entrance into the dreaded “waiting period” where the dead zone begins of increasing anxiety, angst and upheaval of awaiting “the decision” from the Office of Personnel Management.

During this time of waiting wasteland, it is difficult to remain productive if one is no longer working at the Agency, and it is easy to fall prey to the mentality of comparison — of attempting to obtain information on other filings, of other Federal or Postal employees, either current, fairly recent, or in the far past, and attempting to gauge the success or failure, the waiting period, whether some have been preferentially treated, etc.

The problem with engagement in such comparisons, of course, is that it is almost impossible to recreate an apple in order to compare it to another apple. Whether because the internal procedures of OPM have changed (which it has), and comparing it to a time passed when procedures reflected a more systematic methodology of review; or whether one attempts to figure out if there is a non-arbitrary system of review at OPM (there isn’t); or whether the case has been assigned to a more experienced case-worker as opposed to one who has newly come on board at the Office of Personnel Management; or whether the strength of one’s medical and other substantiating documentation makes the initial review for OPM to grant the case immediately — all are factors, and many more not delineated herein, which make for differences between cases which cannot be compared.

Each case is unique; uniqueness is the differentiation between cases; the cases, because of each individual uniqueness, fails in all attempts at quanitification of comparative analysis.

I have represented more people at the Reconsideration Stage of the Federal Disability Retirement process for FERS & CSRS employees, of Federal and Postal employees who filed the initial application on his or her own because it was thought that it was a “slam dunk” case.

That is the problem with the slam dunk case — either the individual thinks that the medical evidence is so overwhelming that little or no effort needs to be expended in order to obtain an approval from the Office of Personnel Management, or if some minimal effort is engaged in, then the problem must be that the people over at the Office of Personnel Management either did not understand the seriousness of the medical conditions, or they misread X or Y, or some other such reason.

The real problem is that there are few, if any, slam dunk cases.

Inasmuch as the applicant who is filing for Federal Disability Retirement benefits personally feels the pain, discomfort, and debilitating nature of the medical conditions from which he or she suffers, therefore it is often (wrongly) assumed that the same feelings can be imparted upon the person reviewing the Federal Disability Retirement application.

One must always keep in mind, however, that a Federal Disability Retirement application under FERS or CSRS is a paper presentation. As such, the effort of compiling, arguing, persuading and explaining must always be engaged in. There are no such cases as slam dunk cases. If there are, I haven’t recently come across one.

When an OPM Disability Attorney cites the law as a supporting, authoritative basis upon which a Federal Disability Retirement application (in part) should be approved, one hopes that the proper and relevant legal authorities are “matched” with the factual and medical issues which are presented. When a lay, non-attorney applicant for Federal Disability Retirement application under FERS or CSRS attempts to refer to, cite, or otherwise “tie in” legal authorities as supporting authority, it is more often the case that the law is inappropriately used, referred to, and misquoted. This is not necessarily because the law is so esoteric a discipline that non-attorneys cannot “use” the law for one’s advantage; rather, what is often the case is that too much “cutting and pasting” occurs, as opposed to actually reading the cases, statutes, and regulatory references, and attempting to first understand the import, relevance and significance of the laws, statutes, legal opinions and regulations surrounding, supporting, and directly impacting upon Federal Disability Retirement issues. On the other hand, if you are going to file a Federal Disability Retirement application, and you decide to cite the law as supportive authority, take a word of wisdom from an ancient adage: An individual who represents himself more often than not has a fool for a client.

In preparing and submitting an application for Federal Disability Retirement benefits under FERS & CSRS, it is important to know your own case. This will often take some time and effort, but it is worthwhile, for many reasons: Knowing and understanding the extent to which your doctor will support you; understanding fully the medical terminology which your doctor has used; knowing that what you say in your Applicant’s Statement of Disability (SF 3112A) does not contradict or otherwise invalidate what your doctor states in his or her medical report — these are all important aspects of a Federal Disability Retirement case.

Often, doctors use medical terminology which, read in the context in which it is written, can be misunderstood and mininterpreted. Such misreading then leads to a misstatement by the applicant in his or her Applicant’s Statement of Disability, thinking that it is supported by the medical documentation which is submitted. Even if it is an honest error, such a self-contained contradiction can harm a case, as when the Office of Personnel Management is able to point to a doctor’s report and is able to state: While you claim X, your own doctor states Y…

It is not the forms which make it complex — although, the instructions which accompany the filling out of the Standard Forms make it appear more convoluted than necessary. Federal Disability Retirement for FERS & CSRS employees of the Federal Government and the U.S. Postal Service is actually quite simple in conceptual terms, and in the process of attempting to win an approval from the Office of Personnel Management, we encounter the complexity of the entire administrative process, thereby overlooking the simplicity of the actual law underlying the process. That is why it is often a good idea to periodically pause and “go back to basics” before moving forward on a disability retirement application.

As stated multiple times, disability retirement is essentially the linking of a “nexus” between one’s medical conditions, and one’s Federal or Postal position. By “linking” is meant the following: Does the medical condition from which one suffers prevent one from performing one or more of the essential elements of one’s job? If the answer to the question is “yes”, then you have passed the preliminary, fundamental, preconditional question.

The next question, or series of questions, of course, include the following: Do you have the minimum of 18 months of Federal Service (for CSRS individuals, 5 years)? Do you have a supportive doctor? Will your medical condition last for at least 1 year? These are just some of the basic, preliminary questions to ask, before considering the option of filing for Federal Disability retirement benefits. The questions and answers themselves are simple; as one gets more and more involved in the process, they become, in combination, procedurally and substantively a complex issue of meeting the legal criteria for approval. Underlying it all is a simple conceptual basis; the complexity comes in applying the law.

I get calls all the time by people who tell me that they thought their particular Federal Disability Retirement case was a “slam dunk”; that the medical documentation was there; that everything looked like it should be approved at the first level. Then, there are people who tell me the same thing after the second, Reconsideration denial — that he or she thought it should definitely pass through. But law, and especially administrative law before the Office of Personnel Management, has peculiarities beyond a surface, apparent reality. There is a process and a methodology of obtaining disability retirement. Can a federal disability attorney guarantee the success of a disability retirement application? No. Does an individual applicant have a better chance with the assistance of an attorney who specializes in disability retirement law? In most cases, yes. Aren’t there applicants who file for disability retirement, without the assistance of an attorney, who are successful? Yes. Should everyone who files for disability retirement hire an attorney? Not necessarily.

When I speak to a client, I try and place him or her on a spectrum — and on one side of that spectrum is an individual who works at a very physical job, and who has such egregious physical medical disabilities; on the other side of the spectrum is an individual who suffers from Anxiety, who works in a sedentary administrative position (please don’t misunderstand — many people who suffer from anxiety fall into the “serious” side of the spectrum, and I am in no way attempting to minimize the psychiatric disability of Anxiety). Most people, of course, fall somewhere in the middle. Yes, I have told many people to go and file his or her disability retirement application without an attorney. There are those cases which are so egregious, in terms of medical conditions, that I do not believe than an attorney is necessary. However, such instances are rare. Thus, to the question, Should everyone who files for Federal disability retirement under FERS & CSRS hire an attorney? Not necessarily — but in most cases, yes.

Seven False Myths about OPM Disability Retirement

1) I have to be totally disabled to get Postal or Federal disability retirement.
False: You are eligible for disability retirement so long as you are unable to perform one or more of the essential elements of your job. Thus, it is a much lower standard of disability.

2) My injury or illness has to be job-related.
False: You can get disability even if your condition is not work related. If your medical condition impacts your ability to perform any of the core elements of your job, you are eligible, regardless of how or where your condition occurred.

3) I have to quit my federal job first to get disability.
False: In most cases, you can apply while continuing to work at your present job, to the extent you are able.

4) I can't get disability if I suffer from a mental or nervous condition.
False: If your condition affects your job performance, you can still qualify. Psychiatric conditions are treated no differently from physical conditions.

5) Disability retirement is approved by DOL Workers Comp.
False: It's the Office of Personnel Management (OPM) the federal agency that administers and approves disability for employees at the US Postal Service or other federal agencies.

6) I can wait for OPM disability retirement for many years after separation.
False: You only have one year from the date of separation from service - otherwise, you lose your right forever.

7) If I get disability retirement, I won't be able to apply for Scheduled Award (SA).
False: You can get a Scheduled Award under the rules of OWCP even after you get approved for OPM disability retirement.